| NPI | 1073877064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN J. COON Resident 630-452-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |